| NPI | 1396227609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN COOPER JOHNSON Pmhnp 928-985-1495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11496) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2020-03-04 |